Cardiac implantable electronic devices have been a cornerstone in the management of arrhythmias for decades, but recent advancements are poised to reshape the landscape of cardiac care according to GlobalData, a leading data and analytics company.
Among these innovations is the extravascular implantable cardioverter defibrillator (EV-ICD), a revolutionary technology that Medtronic has pioneered with its Aurora EV-ICD system. With its advanced capabilities and minimally invasive design, GlobalData says the Aurora EV-ICD is set to shift ICD market dynamics, challenging the dominance of Boston Scientific in the space.
Joselia Carlos, Senior Medical Device Analyst at GlobalData said: “Medtronic has once again demonstrated its leadership in cardiac innovation with the launch of its Aurora EV-ICD device. Unlike traditional ICDs, which place leads inside the heart, and subcutaneous ICDs (S-ICDs), which place leads just beneath the skin, the Aurora places leads outside the heart and vascular system, while still within the thoracic cavity. This novel positioning further reduces the risks associated with direct heart contact, offering a safer alternative for patients.”
Boston Scientific has long dominated the S-ICD market with its Emblem S-ICD, a subcutaneous system designed for patients who need defibrillation but do not require pacing. However, since Aurora‘s FDA approval in 2023, revenue generated by the Emblem device in Q1 2024 was over 20% lower than previous years’ Q1s.
Carlos added: “Medtronic is well-positioned to not only compete with Boston Scientific but to potentially capture market share as more clinicians and patients recognise the advantages of this new EV technology. While the Emblem S-ICD is known for its simplicity—placing leads beneath the skin without entering the heart— its limitations in pacing support may drive patients and healthcare providers toward Medtronic’s Aurora system, addressing a broader range of clinical needs.”
The growing success of the Aurora EV-ICD raises an important question: will EV-ICDs eventually replace S-ICDs? While EV-ICDs present numerous advantages, factors such as cost, reimbursement, and patient-specific needs will determine whether EV-ICDs will outplace S-ICDs or not.
Carlos concluded: “While it’s too early to say whether the EV-ICD will completely replace S-ICDs, Medtronic’s innovation has set a new benchmark for the future of defibrillation therapy. As adoption increases and more clinical data emerges, the Aurora EV-ICD is well on its way to transforming cardiac care.”